Packaging and Labeling Critical for Emergency Response

Recent distribution of supplies from the Strategic National
Stockpile in response to the H1N1 outbreak demonstrate
that preparations could benefit from more unit
packaging and identification.

The H1N1 influenza virus did spread throughout the United States, but the good news is that other things spread, too, and fast. In response to the first cases of H1N1 in the United States, the Centers for Disease Control (CDC) dispersed supplies from the Strategic National Stockpile (SNS) to affected states. Antiviral medications and related supplies arrived within 12 hours of shipment.

One silent partner in the distribution was Upp Technology (Downers Grove, IL). The logistics software and services company sent six IRMS emergency management support teams to assist various client states with receipt and distribution of the CDC shipments.

In 2008, Reuters reported that the District of Columbia had selected Upp Technology’s IRMS Emergency Management System (irmsEM) as well as the IRMS Mobile Emergency Response System (Go-Kit) for mobile SNS inventory management. IRMS was to track drugs, vaccines, supplies, and assets; the Go-Kit was for SNS supply management and control in the field.

In this year’s H1N1 outbreak, 25% of the stockpile was dispensed in what are called “federal assets,” which are essentially large quantities of personal protective equipment and antivirals, says Carl Brewer, president of Upp Technology. Upp’s irmsEM software helped state employees receive, categorize, and distribute CDC shipments, some of which were as large as 300 pallet loads of inventory. “Each state had to receive and divide or apportion this inventory immediately in order to respond to the situation,” explains Brewer. “When dealing with a critical event, one element you never have enough of is time.”

First, CDC shipment contents must be received, examined, and verified. Says Brewer: “States have to be able to identify what supplies actually did show up and accurately identify the specific lot numbers and expiration dates of the critical supplies before moving them downstream in a statewide distribution.”

All of this verification has to take place on the fly, in the field. Upp’s mobile platform employs inventory allocation wizards that are preconfigured to understand CBRNE (Chemical, Biological, Radiological, Nuclear and Explosives) events, at the line-item level. “We brought supply-chain logic to the field, enabling the state to manage the girth of an SNS deployment or simply set up a flu clinic,” says Brewer.

In the H1N1 scenario, Upp’s irmsEM solution enabled states to produce “pick lists” for deployment and distribution to specific locations. Because only the supplies inside the case were bar coded, state employees had to spend additional setup time to prelocate each item prior to picking to ensure there were no distribution errors. For the few items that did provide case-level bar codes, simple scans allowed for quicker distribution.

In addition to its IRMS warehouse management suite, Upp has added additional systems that bring tracking to healthcare reimbursement and other practices. A Clinical Management solution allows tracking and identification to link to Medicare/Medicaid reimbursement, for instance. Additional modules allow recordkeeping for tracking purchases and quantities by funding sources, such as programs covered under STD control funding or other public-health programs.

An Emergency Management Suite allows first responders to manage crowds of patients. In the field, patients can be registered, triaged, and treated. Using HL7 protocols, electronic data can be gathered and recorded for feeding into public health systems. These suites weren't widely used in response to the H1N1 outbreak, but many states were in position to utilize them. “Many of our clients are now reviewing what happened and what they could have done better,” says Brewer.

For instance, unit packaging may help reduce “exposure,” adds Brewer. “A gaylord of 50,000 tablets in bulk becomes a candidate for mistakes. Distributors have to maintain control of that bulk and ensure that lots aren’t comingled. One client of ours doesn’t want this sort of vulnerability, so the firm is tracking down to the pill.” ■